Surgical instrument



D 1941- J. JANNETTO ETAL 2,265,732

SURGICAL INSTRUMENT Filed Sept. 13, 1940 Inventnra and .Jmhn .Jannet'tm Joseph .JannE-ttu Patented Dec. 9, 1941 SURGICAL INSTRUMENT John Jannetto and Joseph Jannetto,

Milwaukee, Wis.

Application September 13, 1940, Serial No. 356,676

4 Claims.

This invention appertains to surgical instruments, and more particularly to a novel device for facilitating sutural work.

In making sutures after abdominal operations and the like, great care must be taken to see that only the integument is closed, without the fastening of any extraneous tissues thereto, whereby to lessen the possibility of adhesions and the like.

It is, therefore, one of the primary objects of our invention to provide an instrument for insertion into the incision after an operation and under the integument around the incision for forming an effective backing and guard during the taking of stitches for closing the incision.

Another salient object of our invention is to provide a surgical instrument which can be collapsed into a small compass, whereby to facilitate the insertion thereof into the wound and to facilitate the removal of the instrument after the incision has been closed up to the drain open- A further object of our invention is the provision of a collapsible surgical instrument for facilitating the making of sutures, which includes a plurality of pivotally connected leaves or blades and means for spreading and collapsing the leaves or blades.

With these and other objects in view, the invention consists in the novel construction, arrangement, and formation of parts, as will be hereinafter more specifically described, claimed, and illustrated in the accompanying drawing, in which drawing:

Figure 1 is a top plan view of our improved surgical instrument, showing the same in use, the incision being closed up to the drain opening, and the instrument being ready to be collapsed and withdrawn from the wound.

Figure 2 is a top plan view of our instrument, showing the same on a larger scale than Figure 1, with parts thereof broken away and in section.

Figure 3 is a view similar to Figure 2, but showing the instrument closed or in its collapsed position, the view also showing the opposite side of the instrument from that disclosed in Figure 2.

Figure 4 is a longitudinal sectional view taken on the line 44 of Figure 3, looking in the direction of the arrows.

Figure 5 is a transverse sectional view through the instrument, taken on the line 5-5 of Figure 2, looking in the direction of the arrows, the view being on a greater scale than that shown in Figures 2 to 4, inclusive.

.Referring to the drawing in detail, wherein similar reference characters designate corresponding parts throughout the several views, theating handles l0 and H are the leaves or blades which are adapted to be inserted into the in-' cision.

In Figure l, we have shown the instrument in use, and the incision is indicated by the reference character 1, and the integument 8 is closed by stitches 9 up to a certain point, which leaves an opening 6 for the removal of the collapsed instrument and for drainage purposes.

The leaves or blades are six in number, but, obviously, this number can be increased or decreased without departing from our invention. As illustrated, we have provided an innermost leaf or blade l4 and an outermost blade or leaf l5. Between the innermost leaf Hi and the outermost leaf I5 is a pair of central leaves, indicated respectively by the reference characters I! and I8, and between the central leaves I! and. I8 and the innermost leaf or blade l4 and the outermost leaf or blade l5 we arrange intermediate blades or leaves l9 and 20.

All of the blades'or leaves, with the exception of the leaf or blade M, are of a U-shape in cross section, and the innermost leaf or blade 14 is adapted to collapse within the leaf or blade 19, and the blade I9 is adapted to extend into the blade I1, and the blade I! is adapted to collapse or move into the blade l8, while the blade I8 is adapted to move into or collapse in the blade 20. The blade 20 is adapted to move into and collapse into the blade [5. Consequently, when the instrument is in its collapsed position, all of the blades are fitted and housed within the outermost blade l5.

All of the blades at their rear ends are pivotally mounted upon a, common pivot pin 2|. The innermost and outermost leaves and blades l4 and I5 are provided with rearwardly extending operating arms 22 of the same length, and these arms 22 are pivotally mounted by pivot pins 23, respectively, to the operating or actuating handles I0 and II. The two central blades or leaves I! and I8 are provided with rearwardly extending, relatively short operating arms 24, and these than the arms 24, and terminate between the;

ends of the arms 24 and the ends of the arms 22.

By this construction and arrangement, upon 7 the operation of the handles, the blades or' -leaves will be operated thereby to an open or closed position according to the directionofthe movement of the handles relative to one another.

In order to insure the accurate movingof. the

blades or leaves to a complete open position relative to one another andto a complete closed, col lapsed position relative to one another, and to prevent the opening of the leaves or blades totoo great an extent beyond v each other, theouter edges of the leaves or blades on one side are provided with intumed lugs 28, which are received in notches 29 in the next adjacent blades or leaves.

Ihe cooperation of the lugs 28 and the walls of the notches 29 bring about the opening of the leaves or blades to their'full extent.

To bring about the complete closing of the blades, the inner edges thereof are provided with inturned lugs 30, and these lugs are received in. notches 3| formed on the inner edges of adjacent blades.

When the instrument is in its complete opened position, accidental collapsing thereof is prevented by a toggle 32, which consists of links and 34, pivotally connected together and to the hand'les I and II. 'Thepivot'pin 3.5 employed for connecting the links 33 and 34 together can carry an operating fing'erpiece 36, and: a part of the fingerpiece, indicated by the reference character: 31, can extend over the-outer edges of the links to abut the same when the links are in'their 45 spread condition. y

In useof our improved instrument, when it is desired to close an incision after an operation, the handles "land I I are moved toward one another,

1 ,Which will collapse the blades or. leaves, so that all of the blades or leaves are enclosed or housed within the outermost. blade or leaf I5.

The instrument S isnow inserted in the incision, and the handles are carefully spread apart, so as to move the blades or leaves to an open fanlike position under the integument, so as toform a backing therefor and a guard for the tissues lying inward of the incision. After the blades or 1 leaves have been spread to their complete open position and are held against'collapsing by the links 33 and 34, the physician proceeds to close I the incision in the ordinaryway by the stitchesB.

The incision is closed at the end remote from the handles I0 and I I,. and when-the incision has been closed with the exception of a small opening, the links 33 and 34 are pulled back, so'as'to I break the toggleby the fingerpiece 36, and the handles I0 and II are swung toward one another,

so as to collapse the instrument by moving all of the blades into the outer blade I5. The instrument can now be easily and successfully moved out of the incision through the small opening 6 (see Figure 1), This opening can be closed by the use of an additional stitch or left open, as is the usual practice for drainage purposes.

From the foregoing description it can be seen that we have provided an exceptionally simple instrument, which will facilitate the closing of incisions.

,',Ch'anges in details may be made without departing from the spirit or the scope of our invention, but what we claim as new is:

l. 'A surgical instrument for facilitating the making of sutures comprising, a pair of operating handles pivotally connected together at their forward ends, fingergrips on the rear ends of the handles; a=plurality of blades pivotally connected together at their rear ends, and rearwardly extending operating arms of different lengths pivotally connected to the handles in 'rear'of' the pivot point of the blades. 1 I W 2. A surgical instrument for facilitatingthe making of sutures comprising, a pair of operatinghandles pivotally connected together at their forward ends, fingergrips on the rear ends ofthe handles, a plurality of blades pivotally connected together at their rear ends, rearwardly extending operating arms of different lengths pivotally connected to the handles in rear of the pivot point of the blades, and interlocking means-between the blades for limiting the opening movement of the blades and for insuring the carrying of the blades to a full, openposition. V

3. A surgical instrument for facilitating the makin of sutures comprising, a pair ofroperating handles pivotally connected together-at I their forward ends, fingerg-rips on the rear. ends of the handles, a plurality of bladespivotally connected together at their rear ends, rearwardly extending operating arms of different lengths piv-,

otally connected to the handles in" rear ofvthe pivot point of theblades, interlocking meansi'between the blades for limiting the opening movement of the blades and forinsuring the carrying. of the blades to a full, open position, andadditional means between the blades for insuringthe closing of the blades to their complete collapsed position.

4. A surgical instrument for facilitating the making of sutures comprising, a pair of operatingv handles pivotally connected together at their. forward ends, operating fingerpieces on the rear ends of the handles, a plurality of blades pivotally connected together at their rear ends infrontof the pivot point of the handles, rearwardly extending. operating crank arms formed on the rear ends-of the blades, said arms being of different lengths, means pivotally connecting the arms tothe handles in rear of the pivot point of the handles,;and means for holding the handles andthe blades against accidental collapsing when the handles are spread apart and the blades are in their full, open, operative position. l

JOHN JANNETTO. 1 JOSEPH VJANNIETTO. 

